Objective   Small-cell esophageal cancer (SCEC) is a rare malignant tumor. Radiotherapy and chemotherapy have been considered as standard treatments for limited-stage SCEC (LS-SCEC). This study aimed to analyze the comprehensive treatment and prognosis of extensive-stage SCEC (ES-SCEC).

  Methods   We retrospectively analyzed the clinical data of 35 Patients with ES-SCEC from the Cancer Hospital of Tianjin Medical University between January 1989 and April 2012.

  Results   A total of 33 patients (94.3%) participated in follow-up visits. The overall survival of the patients ranged between 0.6 and 42.4 months with a median of 9.5 months. All of the patients suffered from extensive metastasis. Among these patients, 33 manifested metastasis at diagnosis and 2 showed metastasis after surgery. One- and two-year survival rates were 27.2% (9/33) and 9.0% (3/33), respectively. Univariate and multivariate analysis results revealed that the number of chemotherapy cycles (≥4) is a risk factor of OS (P=0.02) and the only independent risk factor (P=0.049).

  Conclusion   ES-SCEC is a malignant tumor with poor prognosis. Radiotherapy could not improve patient survival. Chemotherapy combined other therapeutic procedures could be considered as an effective treatment.